Health Care

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 Garuda.Chanti
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By Garuda.Chanti 2019-12-17 19:40:02
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So this dude who used to be a Cigna vice president, Wendell Potter, has become a huge critic of his former industry and an advocate for Medicare for All.

11 part must read twitter thread on "choice."

https://twitter.com/wendellpotter/status/1206623259698974724

Quote:
Lately I've noticed some Democratic politicians defending the current healthcare system by saying it preserves "choice" for Americans. As a former health insurance exec who helped draft this talking point, I need to come clean on its back story, and why it's wrong and a trap.
1/11
 Asura.Saevel
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By Asura.Saevel 2019-12-17 20:35:31
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American doesn't have a "system", that would imply centralized management.

Instead we have a dozen or so smaller "systems" most private but a few public, all operating to varying degree's of success. The worse by far is Medicare, second is probably Tricare, after that it's about how much money someone has.

The USA has the highest quality of healthcare in the world, that quality comes at an astronomical price tag. Furthermore the entire health costing system is hidden behind a barrier of *** numbers. Like on paper they say $10,000 for a procedure, in reality they only charge %5,000, unless it's to medicare then they charge higher. The way medicare pays, it's a percentage of billed price "within reasonable norms", meaning the average of the providers who accept medicare. If they all agree to charge around $10,000 for the procedure, then medicare will pay the percentage of that, while folks with insurance pay less.

"Medicare for all" will just jack up our health costs into the truly obscene because it fails to address the root cause of the issue, and that's costing.

See the USA is subsidizing the worlds pharmaceuticals, their all developed here and make most of their money in the US market. They then sell to other nations for those socialized prices because it's extra revenue outside of their cost recuperation model. Should the US suddenly clamp down on prices, the manufacturers would either cease researching newer drugs or severely restrict what they do research. Nine out of ten experimental drugs fail testing, half do so after they pass initial animal trials. That is a ton of sunk costs that tenth drug has to cover for. Furthermore, due to our tort system and healthcare regulations, there is no low cost option available. It's either door side limousine service or driving a moped.

That last one is something me and my wife talk about all the time. See she's from South Korea which has a health model that's very different from the gold plated Gucci one we have or the obnoxious one that European countries have. There the government doesn't tell healthcare providers what they can charge, only what the government will pay for something like 80% of common procedures. While also relaxing the requirements on how providers can run their clinics. And by relaxing I don't mean sanitation, but they don't have stupid ***like "admitting privileges" or required to have ten different specialists on call 24/7.

The cities have a handful of really big University Hospitals, outside of that it's a bunch of smaller "hospitals" that we would call urgent care clinics. Some are equipped with an OR or other high end facility, but most aren't. Believe it or not but this takes care of most needs at a reasonable cost to the population. It keeps costs low and gets care to the general population at costs they can afford, not pretty but practical. As for doctors, well plenty of those and they don't make near the amount of US ones, at least not in their first years. They also don't have mountains of student debt piled on that they have to work through.

Anyhow, the issues with the US is more about over regulation coupled with very shady pricing tactics. At current prices, "medicare for all" ends up a giant wealth redistribution from middle class Americans to the liberal elites. Rich people won't pay anymore in taxes, all their money is already safeguarded in capital investments. After all you liberals still think wages are an actual source of wealth.
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 Garuda.Chanti
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By Garuda.Chanti 2019-12-17 21:48:22
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Asura.Saevel said: »
American doesn't have a "system", that would imply centralized management.
Agreed

Quote:
The USA has the highest quality of healthcare in the world....
By any health care metric you can name WE DO NOT.
Lifespan, infant mortality, deaths in childbirth, we are rock bottom of first world nations and behind a few third world nations.

Quote:
"Medicare for all" will just jack up our health costs into the truly obscene because it fails to address the root cause of the issue, and that's costing.
Actually the Koch foundation found out that medicare for all would WAY MASS be cheaper.
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By 2019-12-18 00:24:53
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 Asura.Saevel
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By Asura.Saevel 2019-12-18 07:29:59
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Garuda.Chanti said: »
By any health care metric you can name WE DO NOT.
Lifespan, infant mortality, deaths in childbirth, we are rock bottom of first world nations and behind a few third world nations.

That's not what I said.

We have the best healthcare in the world, every wealthy mofo on the planet comes here for surgery and other high end treatments. We have the best medical equipment, best trained doctors, best staffed facilities and so forth. We have that because the tort system requires that we have that "quality of care". That in turn jacks the price up so high that people only use it when it's an "emergency" and unfortunately by then it's normally too late.

What your talking about is access to care, which is terribly bad in most places.

Garuda.Chanti said: »
Actually the Koch foundation found out that medicare for all would WAY MASS be cheaper.

The cost increase comes from it being a government program. I already explained how providers play with numbers to milk even more money out of that system then they do normal payers. Regular insurance companies know the games providers play, medicare is run by government folks who, best case scenario, just want to do the minimum to get a pension.
 Odin.Slore
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By Odin.Slore 2019-12-18 07:52:06
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We do have amazing healthcare in the US. Look at how many specialized cancer treatment centers there are, Roswell Park, Mayo Clinic, Cleveland Clinic, Cancer treatment centers of america. There are a ton of amazing centers....and if you think you are going to be covered by a Obamacare plane to go there you are nuts. Maybe a top tier platinum package but I doubt even that. It is not about the services offered, it's about affording them. You think you are going to go to Roswell or CTCA on medicare and get a full ride, nah.

My Mom went to Rosewell in Buffalo. She had Medicare and my dad's private insurance. They still paid thousands out of pocket, like $20,000.

It's not care it's affordability. Why is it cheaper for me to take my prescription and drive to Canada to get meds for my family. Wife is Diabetic, we get her insulin from Canada at a mere fraction of the cost.
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 Asura.Saevel
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By Asura.Saevel 2019-12-18 08:25:34
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Odin.Slore said: »
Why is it cheaper for me to take my prescription and drive to Canada to get meds for my family.

Because Canada sets the price for prescription medication, most countries do.

Quote:
See the USA is subsidizing the worlds pharmaceuticals, their all developed here and make most of their money in the US market. They then sell to other nations for those socialized prices because it's extra revenue outside of their cost recuperation model. Should the US suddenly clamp down on prices, the manufacturers would either cease researching newer drugs or severely restrict what they do research. Nine out of ten experimental drugs fail testing, half do so after they pass initial animal trials. That is a ton of sunk costs that tenth drug has to cover for.

Manufacturing a medication costs pennies per dose due to economy of scale, the real cost is in the tens to hundreds of millions of USD spent in researching not only that medication but the nine others that failed trials. The price to research is only going up as more complex medication requires more complex research, especially in the area's of retrovirus's which really are the next wonder drug.

It's the same reason all those nations can have "national security" for a fraction of the cost that the USA pays.

Then we got some of the really really stupid ***, like price fixing and pseudo monopolies.

Why is insulin so expensive

Yeah some really anti-competitive behavior there, and this is when the US government gets involved. Not in a liberal "we're looking for criminal activity" because you won't find any, but in a "there is anti-trust behavior and we're gonna break your company up" way. That alone will scare those executives into ceasing with the stupid ***.

You don't threaten business executes with jail time they'll never serve, you threaten them with billion dollar losses they most certainly will realize.
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 Bahamut.Ravael
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By Bahamut.Ravael 2019-12-18 10:06:38
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Exactly. Too many countries benefit from our R&D and then turn around and try to claim that they're better than us when they have offered little to nothing in return.
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 Asura.Saevel
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By Asura.Saevel 2019-12-18 11:44:52
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Bahamut.Ravael said: »
Exactly. Too many countries benefit from our R&D and then turn around and try to claim that they're better than us when they have offered little to nothing in return.

Typical liberal statement:
"Oh American healthcare is so terrible, it's so bad it's akin to a third world country"


My Response:
Then why does all the research happen here and why do all the worlds wealthy elite come here for cutting edge treatments?


Ultimately it's a matter of cost because somehow in the USA, the idea that the poor should get the same medical care as the wealthy is pushed. Economics disagree's heavily with that and any attempt to force it results in wildly skewed results.
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By 2019-12-18 11:49:06
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 Shiva.Thorny
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By Shiva.Thorny 2019-12-18 12:21:27
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DirectX said: »
Why is everyone fat in Americadeveloped countries?

because processed food is cheap and easy, and eating a variety of healthy food is more expensive and requires learning to cook

and US is not even top 10 highest % obesity, the well off arab countries and many of the pacific island countries are worse
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 Shiva.Zerowone
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By Shiva.Zerowone 2019-12-18 12:37:34
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Shiva.Thorny said: »
many of the pacific island countries are worse

Pacific Island cultures put a positive social status on being obese. While it’s not untrue it’s a bit of an exception/asterisk.
 
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By 2019-12-18 14:14:15
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 Shiva.Thorny
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By Shiva.Thorny 2019-12-18 14:21:01
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DirectX said: »
ready meals that don't literally taste like radioactive gruel

us americans don't care, as it all has the same ridiculous sodium density such that you can't taste anything else

idk what you're angling for asking the question when you already have your own answer in mind, but it's pretty obvious that people eat like ***because of a combination of:

-it's cheap
-it's easy
-it's a coping mechanism
-sodium and sugar are both addictive and both are plentiful in ***food
-a shitton of americans don't know how to cook properly, or don't feel like they have time to cook properly
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By 2019-12-18 14:38:36
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By 2019-12-18 17:10:23
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 Asura.Saevel
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By Asura.Saevel 2019-12-18 17:21:16
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kireek said: »
You know you live in a great country when nobody is dying of starvation and the biggest complaint is they are fat due to eating too much.

No ***right. Like damn near half, if not more, of our health problems stem from overeating and a bad lifestyle. Having 30% or higher body fat percentage creates a giant list of health issues, many with dire long term impacts.

That's another thing me and my wife really noticed upon returning to the USA, the portion sizes have ballooned. Like a single serving of food is enough for two or more people.
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 Garuda.Chanti
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By Garuda.Chanti 2019-12-18 17:59:33
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kireek said: »
You know you live in a great country when nobody is dying of starvation and the biggest complaint is they are fat due to eating too much.
Of the wrong stuff.
 
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By 2019-12-20 02:54:28
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 Odin.Slore
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By Odin.Slore 2019-12-20 05:01:59
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I am very against healthcare for all for a few reasons:

1.) it's expensive as hell
2.) I shouldn't have to pay for your bad *** lifestyle. Eating ***fast food, smoking, drugs, no exercise etc. You wanna die early or have heart problems, knock yourself out. Why the hell am I forced to pay for your laziness or poor decisions. I take care of myself so I don't have to pay for that stuff for myself, sure as hell shouldn't have to pay for yours. People are dumb. Smoke for 40 years and then be all surprised when your *** gets lung cancer...or eat fast food 3-4 times a week with a Dave's Triple with cheese large combo then complain your fat and got heart issues. Miss me with that ***.

It is not that I have no compassion or that I don't care, I am in healthcare field, but people need to stop blaming others and take ownership of their ***decisions.

In NY they are trying to pass a law that states you can buy fast food with a EBT (food stamp) card...like seriously...it's like they want people unhealthy so that they have to rely on the government..
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 Asura.Vienner
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By Asura.Vienner 2019-12-20 05:10:42
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DirectX said: »
Why is everyone fat in America?
Everyone is of course a big word. Now the problem has many reasons, an important reason is the ability to produce cheap food (the US is much more lacks on animal wellfare and the use of GM's which makes producing food faster and on a larger scale easier. Its also allowed to use certain hormones in the growing of lifestock which is forbidden here but it has a substantial effect on how much muscletissue a cow has).

It also has to do with social background. Certain population groups live in "ghettoish" situations and this has lead to the vanishing of fruitstores/butchers/bakers in those areas in the favour of discounters. And said discounters often dont often free produce and sell sealed/prefab made food in large quantities. This of course has directly to do with a person's income.
This is a phenomenon you also see here in the larger cities.

And every year we also get these doomsayings that people are getting fatter over here. But this is more a demographic problem which probably partially also is the case in the States. Less younger active people and more older obese people.

I find the excuse that people dont have time to cook is *** tbf, The best action towards a healthier lifestyle is to learn how to cook with a minimum of ingredients and time. It should be offered as a free class to combat obesity. It would be a great social/economic way to invest in healthcare.
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 Asura.Saevel
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By Asura.Saevel 2019-12-20 07:37:43
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Odin.Slore said: »
but people need to stop blaming others and take ownership of their ***decisions.

Well that is a problem for the lefties, they practically sell redistribution of responsibility.
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By 2019-12-20 08:31:21
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 Asura.Vienner
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By Asura.Vienner 2019-12-20 09:39:21
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DirectX said: »
Asura.Vienner said: »
This is a phenomenon you also see here in the larger cities.
The entire population of your country is about the population of London.

You don't have large cities.
Yes, thankfully we dont. Not something we're jealous for. Bigger isnt always better. It doesnt change the higher concentration of poverty in midget cities like ours and big boy cities like yours compared to small towns.
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